Bilirubin nomogram for prediction of significant hyperbilirubinemia in North Indian neonates

Pathak, U. N.; Chawla, Deepak; Kaur, Saranjit; Jain, Suksham

doi:10.1007/s13312-013-0119-8

Cited by 16 publications

(9 citation statements)

References 16 publications

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“…This is consistent with previous studies reported in the literature. 6,9,11 The clinical risk factors such as GA and loss of birth weight in percentage are very good predictors of SHB found in the present study. Studies have suggested that predischarge STB with GA could be a superior predictor for SHB.…”

Section: Discussionsupporting

confidence: 72%

“…8 Pathak, et al also showed that STB and hour-specific bilirubin nomogram could be used for forecast subsequent require of phototherapy. 9 When considered early in the life (at 18-24 hours after birth), STB, using a cut-off value of >3.99mg/dl, could also predict later SHB. 10 However, none of the studies on pre-discharge cut-off value of STB in Indian infants and also none of discovered the combination of STB and clinical risk factors for predischarge assessment in term newborns.…”

Section: Introductionmentioning

confidence: 99%

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Predischarge risk factors for predicting significant hyperbilirubinemia in term of infants

Mehta¹,

Bhatt

Vora

et al. 2019

Int J Contemp Pediatr

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Background: The objective of the study to compare the predictive ability of predischarge serum total bilirubin (STB) and clinical factors for significant hyperbilirubinemia (SHB) in newborn to observe the prediction of the hyperbilirubinemia.Methods: In the prospective study, enlist of healthy newborn infants with >35 weeks gestation, in a tertiary hospital in western India. The serum bilirubin between 36-48 hours of age and risk factors for SHB were identified before discharge. SHB was distinct as a bilirubin level that exceed or was within 1mg/dL (17µmol/L) of the hour-specific phototherapy conduct threshold recommended by American Academy of Pediatrics (AAP) guideline on the management of neonatal hyperbilirubinemia.Results: Of 505 infants, 380 infants were included in final analysis, among which 70 babies (22.5%) developed SHB. On univariate analysis STB, gestational age (GA) and percentage of weight loss were found to be predictive of SHB. On multiple logistic regressions, the prognostic ability of predischarge STB is higher than that of percentage of weight loss and GA. The predictive accurateness of predischarge (<48 hours) STB level was comparable to that of percentage of weight loss (AUC=0.88, 95% CI 0.84-0.93). However, the prediction model that combined multiple risk factors such as predischarge STB, GA and percentage of weight loss have the best accuracy for predicting SHB.Conclusions: Combination of specific clinical factors (gestational age and percentage of weight loss) with predischarge serum total bilirubin described best predicts development of considerable hyperbilirubinemia.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Predischarge risk factors for predicting significant hyperbilirubinemia in term of infants

Mehta¹,

Bhatt

Vora

et al. 2019

Int J Contemp Pediatr

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“…Therefore, before neonates are discharged from birth hospital those at risk of developing high bilirubin levels need to be identified. 7 The purpose of the study is to determine the risk factors associated with development of significant hyperbilirubinemia in newborns, so that we can keep a close follow up of babies who have the risk factors of developing significant hyperbilirubinemia in the future. Also the study is intended to determine the treatment modality for significant hyperbilirubinemia.…”

Section: Introductionmentioning

confidence: 99%

Factors identifying babies at risk for significant hyperbilirubinemia: a prospective study conducted at a tertiary care center

Kale

Sharma

Jain

et al. 2016

Int J Contemp Pediatr

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INTRODUCTIONHyperbilirubinemia is universally present in the newborn period and is recognized as clinical jaundice in approximately 50% infants. The sheer prevalence of neonatal jaundice and periodic occurrence of bilirubin associated encephalopathy ensures sustained interest in this subject. The fear for the level of 20 mg/dl has given anxious moments to doctors and the relatives of the "jaundiced infant". To the pediatrician jaundice remains ABSTRACT Background: Hyperbilirubinemia is universally present in the newborn period and is recognized as clinical jaundice in approximately 50% infants. The aim was to determine the risk factors and treatment modalities of newborns with significant hyperbilirubinemia admitted from September 2011 to August 2013. Methods: One hundred and fifty newborns with significant hyperbilirubinemia, both inborn and outborn were included in the study. Relevent information during hospitalisation was taken. American Academy of Pediatrics (AAP) guidelines were followed to determine the treatment modality. Treatment in the form of either phototherapy or exchange transfusion was given. Results: Out of 150 patients 90 were males and 60 females. Higher values of serum bilirubin were found in the female babies and this difference was statistically significant. One hundred and thirty four babies had a birth weight of more than 2 kgs and 16 less than 2 kgs. The serum bilirubin levels were more in babies more than 2 kgs and this was statistically significant. Ninety one babies were delivered vaginally and 59 by LSCS. Higher serum bilirubin levels were found in those delivered vaginally with the difference being statistically significant .ABO blood group incompatibility was seen in 70 babies, 6 babies with Rh incompatibility. ABO incompatibility resulted in higher serum bilirubin levels with the difference being statistically significant. Ninety six babies had a gestation of more than 37weeks and higher bilirubin levels were found in this group as compared to lesser gestational age baby, the difference was statistically significant. Eighty five patients were admitted before 72 hours of life and 65 after that. Higher serum bilirubin levels were found in those admitted later with a statistically significant difference. The presence of antenatal risk factors (P = 0.4), parity of the mother (P = 0.178) were not found to play a major role in development of significant hyperbilirubinemia. Phototherapy was used as treatment modality in 137 patients, whereas 13 required exchange transfusion. Conclusions: Significant hyperbilirubinemia was found to be more common in female babies, more than 37weeks of gestation, delivered vaginally, with birth weight of more than 2kgs, with ABO blood group incompatibility, admitted after 72hrs of life and with no identified antenatal risk factors. Most commonly used treatment modality found in these cases was phototherapy.

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“…Furthermore, we optimized the conditions to maximize the lipase production and evaluated the solvent stability of lipase using various organic solvents. B. licheniformis has been reported to produce a variety of extracellular enzymes such as protease [14], amylase [15], lipase [16], and xylanase [17]. However, no reports are available on an organic solvent-stable lipase from a solvent-tolerant strain of B. licheniformis.…”

Section: Introductionmentioning

confidence: 99%

Isolation of an organic solvent‐tolerant bacterium Bacillus licheniformis PAL05 that is able to secrete solvent‐stable lipase

Anbu

Hur

2014

Biotech and App Biochem

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In this study, seven lipase-producing bacterial strains were isolated from salt-enriched and cattle farm soil samples after incubation in toluene- and benzene-enriched media. One strain (PAL05) showed significantly greater lipase activity on spirit blue agar medium and stability in organic solvents. The positive strain (PAL05) was identified as Bacillus licheniformis by 16S rRNA gene sequencing. Lipase production was optimized in a medium containing glycerol as the carbon source and Tween 80 as an inducer (0.5% glycerol+0.5% Tween 80) at pH 8.0 and a temperature of 30 °C. In addition, the enzyme was moderately halotolerant as it exhibited increased activity in the presence of 2.5% NaCl. Optimized conditions increased the lipase production threefold. Crude lipase retained its activity for 14 days of incubation in the presence of various organic solvents at a level of 25% and 50%. The enzyme was stable at 25% in most solvents; some of the solvents such as hexane, benzene, and ethanol actually stimulated enzyme activity. The organic solvent stability of the lipase produced by the strain PAL05 enables the enzyme to be used as a potential biocatalyst for ester synthesis and other applications in nonaqueous conditions.

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Bilirubin nomogram for prediction of significant hyperbilirubinemia in North Indian neonates

Abstract: Hour-specific bilirubin nomogram and STB measurement can be used for predicting subsequent need of phototherapy. Further studies are needed to validate performance of risk demarcation zones defined in this hour-specific bilirubin nomogram.

Cited by 16 publications

References 16 publications

Predischarge risk factors for predicting significant hyperbilirubinemia in term of infants

Predischarge risk factors for predicting significant hyperbilirubinemia in term of infants

Factors identifying babies at risk for significant hyperbilirubinemia: a prospective study conducted at a tertiary care center

Isolation of an organic solvent‐tolerant bacterium Bacillus licheniformis PAL05 that is able to secrete solvent‐stable lipase

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